A Case of Earpick Injury with Delayed Facial Paralysis

概要

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We reported a rare case of ear trauma with delayed facial paralysis, ossicular chain dislocation and perilymph fistula caused by an earpick. A 36-year-old male consulted our clinic with a complaint of left otalgia, hearing loss, tinnitus and dizziness after left ear trauma with an earpick. Otoscopic examination showed perforation of the left ear-drum and pure tone audiometory demonstrated a mixed hearing loss with an average air conduction threshold of 53dB on the initial examination. He was diagnosed as having a traumatic ear-drum perforation. Left facial paralysis occurred 6 days after the trauma, then recovered after the intravenous steroid treatment. Hearing impairment did not improve after spontaneous closure of the ear-drum perforation, and exploratory tympanoplasty was performed. At surgery, the incus was dislocated and the anterior and posterior crura of stapes were fractured. Perilymphatic leakage from the fractured footplate was noted. The footplate was covered with temporal fascia and ossicular chain reconstruction was performed using the incus on the foot plate as a columella. Post operationally, the hearing threshold improved with an average air conduction threshold of 31.7dB.